Fred, stage 1-2 chronic kidney disease - advice on food etc

gettingready

Thanks for that.

Both Teddy and Fred are fed the same wet food with the only difference being Teddy eating dry too and being almost 8 yo and Fred being almost 4 yo and never ever touching dry food in his whole life.

Wet they eat Animonda Carny (various flavours) and Butchers Classic (which they prefer) various flavours - with Fred eating more than Teddy as Teddy tops up with dry.

Fred is always hungry, ever since he was a kitten - he finishes his and then has all the leftovers after the others.

He has a shiny coat, is a tiny bit overweight according to vet but to me he looks like a lea purring machine.

In all honesty Fred looks the best of all my boys (shhhhhhhhhhhhh hope they are not reading).

Really baffled.

USG - the only thing I was told was that his kidneys are unusually small for his age/size...

Shoshannah

Hi GR. Sorry to hear about Fred's diagnosis. (((hugs)))

I once wrote a post on interpreting test results in CKD cases on Pet Forums, so I shan't repeat all of it in detail here. The post can be viewed here: http://www.petforums.co.uk/cat-chat/362046-kidney-disease-stage-2-a.html#post1063651336

Fred's current level of azotaemia would place him in Stage 2 on the IRIS Staging System for CKD in cats. However, this is assuming it has been proven that his azotaemia is renal in origin and not pre-renal (ie - due to dietary influences, dehydration, or increased protein breakdown in the body).

This is where the USG comes in and is extremely important. Sorry if I've misunderstood your posts, but by USG do you mean 'Urine Specific Gravity'? If so, this gives no indication as to kidney size, it is purely a measure of urine concentration. The higher the USG, the more concentrated urine.

Normal feline urine is very concentrated (ie it has a high USG - normally more than 1.035). This is especially true if the cat is dehydrated, obviously. So, with an azotaemic cat, you would expect the USG to be high.

If the USG is low (in the case of a cat, anything less than 1.030-1.035 is considered low), then I'm afraid that more or less proves the azotaemia is renal and due to kidney disease. Do you know Fred's USG result?

If Fred is, indeed, in renal failure, then we also need to look at phosphorus. High phosphorus is a result of renal failure, but, cruelly, it also speeds up its progression; it's a true vicious circle. We want the serum phosphorus level of a cat in Stage 2 CKD to be under 1.45, and Fred's is 1.30, which is awesome.

The main point of the renal diets, wet or dry, is to restrict dietary phosphorus intake to help keep those levels low. In studies, dietary phosphorus restriction has been associated with increased survival times in cats with CKD. You say Fred doesn't eat dry, which I think is great (just my opinion, others might disagree) - I'm a fan of wet food for cats anyway, but especially in a situation like this. As you know, you need to increase his fluid intake any way you can.

Keep researching. If you decide a renal diet isn't for Fred, then you could consider adding a phosphate binder to the food such as Ipakitine powder or Renalzin paste. These are, however, generally considered second-line by the experts.

FWIW, my own cat with CKD was fed on generic wet food until the day he died (of something unrelated to his CKD). But it's something you need to research yourself and discuss with your vet.

Has he had any other urine tests performed, or his blood pressure checked? These are important for further substaging of the CKD using the IRIS system, which can provide prognostic information and aid effective treatment.

Hugs for Fred xxx

gettingready

Thanks a lot for posting, will have a look at your link when I get a chance.

Sorry re USG - meant ultrasound....

Fred is stressed beyond belief at each vet trip (not that he had many) - he pants like a dog, shakes and goes out of his mind.

He is a proper homebody, mum's baby and very occasionally goes out.

I only spoke to the vet over the phone (go figure) as he was handed back to me by a nurse as I could not pick him up in working hours - I will see his vet on the 27th when I take Teddy for his post dental check up....

What shall I ask for? Any pointers?

And what about the dental he supposed to have but did not because of blood results?

The poor thing has chewed on the part of his front leg that was shaven - I asked for this be looked into when I dropped him off for the ultrasound but guess what? Nobody looked.

Skin is red there, I am putting sudocream on it, hope it helps him.

Really stressed, both him and me

Thanks again xx

Shoshannah

gettingready wrote: »

Thanks a lot for posting, will have a look at your link when I get a chance.

Sorry re USG - meant ultrasound....

Fred is stressed beyond belief at each vet trip (not that he had many) - he pants like a dog, shakes and goes out of his mind.

He is a proper homebody, mum's baby and very occasionally goes out.

I only spoke to the vet over the phone (go figure) as he was handed back to me by a nurse as I could not pick him up in working hours - I will see his vet on the 27th when I take Teddy for his post dental check up....

What shall I ask for? Any pointers?

And what about the dental he supposed to have but did not because of blood results?

The poor thing has chewed on the part of his front leg that was shaven - I asked for this be looked into when I dropped him off for the ultrasound but guess what? Nobody looked.

Skin is red there, I am putting sudocream on it, hope it helps him.

Really stressed, both him and me

Thanks again xx

Ah, I see. Seeing small kidneys on ultrasound can be a sign of CKD as the kidneys can shrink when they are chronically scarred and failing. So am I right in thinking he hasn't had any urine tests done yet?

I would ask about these at your next visit. He needs a USG to measure his concentration and confirm this is indeed CKD. Ideally he could also do with a culture for possible UTIs (as these are not uncommon in cats with CKD) and, if all clear of that, a UPC measurement (urine protein:creatinine ratio) to see whether he has any protein in his urine. If he does, it needs treatment as it will speed up the progression of CKD.

Blood pressure would be great, but obviously you'd need to take into account his stress levels. If he is really stressed and cannot relax at all, a blood pressure reading won't be accurate and measuring it may be a waste of time.

The dental may not be completely out of the question in the future (we can and do anaesthetise cats with CKD), but it depends on how stable he is. I guess his CKD needs to be addressed first.

Use Sudocrem sparingly - if you slap too much on too often it can really make the skin icky. If it's looking really red and sore then please consider ringing the vet and asking them about it again.

I know it's horrible. Nobody wants to hear that their kitty has kidney issues. I remember feeling pretty down when Orange Cat's bloods finally came back azotaemic (I'd been checking regularly and half-expected it though - he was 14 when he was diagnosed). But in Fred's case it is unexpected and that makes it harder.

I know it's so much easier said than done, but try not to stress too much. You know he'll only pick up on it. If he is in renal failure, his figures suggest that he is only in Stage 2, so things could be worse. CKD is not curable, sadly (in contrast to acute renal failure), but it can be managed and its progress slowed, and some cats live years and years with kidneys that aren't 100%.

Big hugs xxx

Angelicdevil

Sorry to hear about Fred I can't help but have read Shoshannah's posts with interest.

Fluff15

Sorry to hear gettingready. I have no experience on kidney issues, but in regards to encouraging water, some cats enjoy running water and my two drink much more if it's from a running tap, so I tend to leave on the bath tap for my two and they lap it up. You can buy water fountains too, Zooplus usually have offers on.

rising_from_the_ashes

(((hugs))) GR as I know how hard this will have hit you

gettingready wrote: »

vet said to go for renal food....

*shoosh - cover your ears / eyes* (I know you're one of the exceptions) ETA just realised Shoosh is probably scratching her head / wondering how on earth I know! I use PF but with a different user name!


Vets unfortunately don't know a huge amount about pet food - they have very limited training in it - and, for many, the various prescription foods they sell are the only suggestion they can come up with!


There are lots of alternatives .....

gettingready

rising_from_the_ashes wrote: »

*shoosh - cover your ears / eyes* (I know you're one of the exceptions) ETA just realised Shoosh is probably scratching her head / wondering how on earth I know!

.

Know what?

Huh?

What am I missing?

Thanks everyone..

gettingready

Fred did have urine tests done but I did not ask for copies of those.

Will ask for a copy of ultrasound report and urine tests too and when I get those - will post them here.

Thanks again

Shoshannah

gettingready wrote: »

Know what?

Huh?

What am I missing?

Thanks everyone..

You're alright - she's talking about Pet Forums. I did realise it was you... lilylass! Same avatar.